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NPI 1679121180

NPI 1679121180 : LEAH ASHANTI AMARAL MAATC : CLEARWATER, FL

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General NPI Number Information
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    NPI Number           |    1679121180
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    Entity Type          |    Individual 
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    Provider Name        |    LEAH ASHANTI AMARAL MAATC
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    08/28/2019
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    Last Update Date     |    10/25/2024
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Provider Practice Location Address
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    Address Line         |    13575 58TH ST N STE 200 
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    City                 |    CLEARWATER
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    State                |    FL
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    Zip                  |    33760-3739
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    Country              |    US
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    Telephone            |    727-282-5596
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    13575 58TH ST N STE 200 
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    City                 |    CLEARWATER
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    State                |    FL
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    Zip                  |    33760-3739
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    Country              |    US
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    Telephone            |    727-282-5596
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    101YM0800X
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    Taxonomy Name        |    Mental Health Counselor
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    License Number       |    
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    License Number State |    
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Taxonomy #2
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    Taxonomy Code        |    101YP2500X
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    Taxonomy Name        |    Professional Counselor
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    License Number       |    11178-125
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    License Number State |    WI
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Taxonomy #3
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    Taxonomy Code        |    221700000X
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    Taxonomy Name        |    Art Therapist
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    License Number       |    
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    License Number State |    
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Taxonomy #4
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    Taxonomy Code        |    101YP2500X
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    Taxonomy Name        |    Professional Counselor
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    License Number       |    180.016070
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    License Number State |    IL
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